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Chemistry

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Also known as: Thio-tepa, 52-24-4, Triethylenethiophosphoramide, Thioplex, Thiophosphamide, Tiofosfamid
Molecular Formula
C6H12N3PS
Molecular Weight
189.22  g/mol
InChI Key
FOCVUCIESVLUNU-UHFFFAOYSA-N
FDA UNII
905Z5W3GKH

Thiotepa
A very toxic alkylating antineoplastic agent also used as an insect sterilant. It causes skin, gastrointestinal, CNS, and bone marrow damage. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985), thiotepa may reasonably be anticipated to be a carcinogen (Merck Index, 11th ed).
Thiotepa is an Alkylating Drug. The mechanism of action of thiotepa is as an Alkylating Activity.
1 2D Structure

Thiotepa

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
tris(aziridin-1-yl)-sulfanylidene-5-phosphane
2.1.2 InChI
InChI=1S/C6H12N3PS/c11-10(7-1-2-7,8-3-4-8)9-5-6-9/h1-6H2
2.1.3 InChI Key
FOCVUCIESVLUNU-UHFFFAOYSA-N
2.1.4 Canonical SMILES
C1CN1P(=S)(N2CC2)N3CC3
2.2 Other Identifiers
2.2.1 UNII
905Z5W3GKH
2.3 Synonyms
2.3.1 MeSH Synonyms

1. Ai3 24916

2. Ai3-24916

3. Ai324916

4. Girostan

5. Nsc 6396

6. Nsc-6396

7. Nsc6396

8. Tespa

9. Tespamin

10. Thio Tepa

11. Thio-tepa

12. Thiophosphamide

13. Triethylenethiophosphoramide

14. Tris(1-aziridinyl)phosphine Sulfide

2.3.2 Depositor-Supplied Synonyms

1. Thio-tepa

2. 52-24-4

3. Triethylenethiophosphoramide

4. Thioplex

5. Thiophosphamide

6. Tiofosfamid

7. Tiofosyl

8. Thiofozil

9. Tespamin

10. Girostan

11. Oncotepa

12. Tespamine

13. Tiofozil

14. Stepa

15. Tri(aziridin-1-yl)phosphine Sulfide

16. Oncotiotepa

17. Thiotef

18. Tifosyl

19. Oncothio-tepa

20. Tespa

21. Tio-tef

22. Thio-tep

23. Tspa

24. Thio-tepa S

25. Tepadina

26. Ledertepa

27. Thiotriethylenephosphoramide

28. Tris(1-aziridinyl)phosphine Sulfide

29. Tio Tef

30. 1,1',1''-phosphorothioyltriaziridine

31. Nsc-6396

32. N,n',n''-triethylenethiophosphoramide

33. Triethylene Thiophosphoramide

34. Triaziridinylphosphine Sulfide

35. Triethylenethiophosphorotriamide

36. Tris(ethylenimino)thiophosphate

37. Cbc 806495

38. Phosphorothioic Acid Triethylenetriamide

39. Phosphine Sulfide, Tris(1-aziridinyl)-

40. Tri(ethyleneimino)thiophosphoramide

41. Nci-c01649

42. Nsc 6396

43. Sk 6882

44. Tris(aziridinyl)phosphine Sulfide

45. Aziridine, 1,1',1''-phosphinothioylidynetris-

46. Tri-1-aziridinylphosphine Sulfide

47. Tris(1-aziridinyl)phosphine Sulphide

48. N,n',n''-triethylenethiophosphamide

49. N,n',n''-triethylenethiophosphortriamide

50. Nsc6396

51. 1,1',1''-phosphinothioylidynetrisaziridine

52. N,n',n''-triethylenephosphorothioic Triamide

53. N,n',n''-tri-1,2-ethanediylthiophosphoramide

54. Thiophosphoramide, N,n',n''-tri-1,2-ethanediyl-

55. N,n',n''-tri-1,2-ethanediylphosphorothioic Triamide

56. Mls001333083

57. Mls003389372

58. 905z5w3gkh

59. Chebi:9570

60. Phosphorothioic Triamide, N,n',n''-tri-1,2-ethanediyl-

61. Ai 3-24916

62. Phosphorothioic Triamide, N,n',n''-triethylene-

63. Tri(1-aziridinyl)phosphine Sulfide

64. Aziridine,1,1',1''-phosphinothioylidynetris-

65. Ncgc00095042-04

66. Ncgc00095042-06

67. Thiophosphamidum

68. Dsstox_cid_1339

69. Dsstox_rid_76093

70. Dsstox_gsid_21339

71. Thiotepum

72. Tiotepa

73. Thiotepum [inn-latin]

74. Tiotepa [inn-spanish]

75. Cas-52-24-4

76. Smr000058542

77. Ccris 586

78. Hsdb 3258

79. Ai3-24916

80. Sr-05000001855

81. Einecs 200-135-7

82. Brn 0145978

83. Unii-905z5w3gkh

84. Wr-45312

85. Thiotepa [usp:inn:ban:jan]

86. Tepadina (tn)

87. Thioplex (tn)

88. Mfcd00145452

89. Rethio (tn)

90. Thiotepa (thioplex)

91. Spectrum_001689

92. Wr 45312

93. Thiotepa [hsdb]

94. Thiotepa [iarc]

95. Thiotepa [inn]

96. Thiotepa [jan]

97. Thiophosphoramide, N,n',n''-triethylene-

98. Thiotepa [mi]

99. Thiotepa [vandf]

100. Spectrum2_001557

101. Spectrum3_001594

102. Spectrum4_000208

103. Spectrum5_001641

104. Thiotepa [mart.]

105. Tris(aziridin-1-yl)-thioxo-$l^{5}-phosphane

106. Chembl671

107. Thiotepa [usp-rs]

108. Thiotepa [who-dd]

109. Thioplex (tn) (immunex)

110. Tris(aziridinyl)-phosphine Sulfide (thio-tepa)

111. Schembl4760

112. Thiotepa (jan/usp/inn)

113. Thiotepa [ema Epar]

114. Thio-tepa, 98%, Solid

115. Bspbio_003188

116. Kbiogr_000815

117. Kbioss_002169

118. 4-20-00-00052 (beilstein Handbook Reference)

119. Mls001333084

120. Mls002207150

121. Mls006009972

122. Bidd:gt0127

123. Divk1c_000817

124. Spectrum1503324

125. Spbio_001434

126. Tris(aziridin-1-yl)-sulfanylidene-lambda5-phosphane

127. Thiotepa [orange Book]

128. Gtpl7622

129. Dtxsid0021339

130. Thiotepa [usp Monograph]

131. Hms502i19

132. Kbio1_000817

133. Kbio2_002169

134. Kbio2_004737

135. Kbio2_007305

136. Kbio3_002688

137. N,n''-triethylenethiophosphamide

138. Ninds_000817

139. Hms1922a14

140. Hms2093e05

141. Hms2232p17

142. Hms3372d10

143. N,n''-triethylenethiophosphoramide

144. Pharmakon1600-01503324

145. Albb-034802

146. Amy33389

147. Bcp04110

148. Zinc1530867

149. Tox21_111399

150. Tox21_400065

151. Bdbm50418086

152. Ccg-39776

153. Nsc758455

154. S1775

155. Akos005267118

156. Cs-3119

157. Db04572

158. Gc10080

159. Nsc-758455

160. 1,1''-phosphinothioylidynetrisaziridine

161. Idi1_000817

162. Thiophosphoramide,n',n'' -triethylene-

163. N,n',n'''-triethylenethiophosphhoramide

164. Ncgc00095042-01

165. Ncgc00095042-02

166. Ncgc00095042-03

167. Ncgc00095042-05

168. Ncgc00095042-07

169. Ncgc00095042-08

170. Ncgc00095042-09

171. Phosphorothioic Tri(ethyleneamide)

172. Tris(aziridin-1-yl)-

173. E?-phosphanethione

174. As-16885

175. Hy-17574

176. N,n''-triethylenephosphorothioic Triamide

177. Nci60_013117

178. Sbi-0051814.p002

179. Aziridine,1',1''-phosphinothioylidynetris-

180. N,n''-tri-1,2-ethanediylthiophosphoramide

181. Phosphorothioic Triamide,n',n''-triethylene

182. Thiophosphoramide, N,n',n'' -triethylene-

183. Tris(aziridin-1-yl)-lambda5-phosphanethione

184. Ft-0600281

185. Tris(aziridin-1-yl)-$l^{5}-phosphanethione

186. Tris(aziridin-1-yl)-sulfanylidenephosphorane

187. Wln: T3ntj Aps&- At3ntj&- At3ntj

188. 1-[di(1-aziridinyl)phosphorothioyl]aziridine #

189. C07641

190. D00583

191. Phosphorothioic Triamide, N,n',n''-triethylene

192. Thiophosphoramide,n',n''-tri-1,2-ethanediyl-

193. Ab00052346-06

194. Ab00052346_07

195. 145t452

196. A828998

197. N,n''-tri-1,2-ethanediylphosphorothioic Triamide

198. Q416507

199. Q-201826

200. Sr-05000001855-1

201. Sr-05000001855-5

202. 1,1',1''-phosphinothioylidynetris(aziridine)

203. Brd-k09631521-001-05-7

204. Phosphorothioic Triamide,n',n''-tri-1,2-ethanediyl-

205. Z2574360269

206. Thiotepa, United States Pharmacopeia (usp) Reference Standard

207. 1631739-26-8

2.4 Create Date
2005-03-25
3 Chemical and Physical Properties
Molecular Weight 189.22 g/mol
Molecular Formula C6H12N3PS
XLogP30.5
Hydrogen Bond Donor Count0
Hydrogen Bond Acceptor Count4
Rotatable Bond Count3
Exact Mass189.04895557 g/mol
Monoisotopic Mass189.04895557 g/mol
Topological Polar Surface Area41.1 Ų
Heavy Atom Count11
Formal Charge0
Complexity194
Isotope Atom Count0
Defined Atom Stereocenter Count0
Undefined Atom Stereocenter Count0
Defined Bond Stereocenter Count0
Undefined Bond Stereocenter Count0
Covalently Bonded Unit Count1
4 Drug and Medication Information
4.1 Drug Information
1 of 2  
Drug NameThiotepa
PubMed HealthThiotepa (Injection)
Drug ClassesAntineoplastic Agent
Active IngredientThiotepa
Dosage FormInjectable
RouteInjection
Strength15mg/vial
Market StatusPrescription
CompanyEurohlth Intl

2 of 2  
Drug NameThiotepa
PubMed HealthThiotepa (Injection)
Drug ClassesAntineoplastic Agent
Active IngredientThiotepa
Dosage FormInjectable
RouteInjection
Strength15mg/vial
Market StatusPrescription
CompanyEurohlth Intl

4.2 Therapeutic Uses

Antineoplastic Agents, Alkylating; Myeloablative Agonists

National Library of Medicine's Medical Subject Headings. Thio-Tepa. Online file (MeSH, 2016). Available from, as of December 5, 2016: https://www.nlm.nih.gov/mesh/2016/mesh_browser/MBrowser.html


/CLINICAL TRIALS/ ClinicalTrials.gov is a registry and results database of publicly and privately supported clinical studies of human participants conducted around the world. The Web site is maintained by the National Library of Medicine (NLM) and the National Institutes of Health (NIH). Each ClinicalTrials.gov record presents summary information about a study protocol and includes the following: Disease or condition; Intervention (for example, the medical product, behavior, or procedure being studied); Title, description, and design of the study; Requirements for participation (eligibility criteria); Locations where the study is being conducted; Contact information for the study locations; and Links to relevant information on other health Web sites, such as NLM's MedlinePlus for patient health information and PubMed for citations and abstracts for scholarly articles in the field of medicine. Thio-tepa is included in the database.

NIH/NLM; ClinicalTrials.Gov. Available from, as of February 1, 2017: https://clinicaltrials.gov/ct2/results?term=THIO-TEPA&Search=Search


Thiotepa for Injection, USP has been tried with varying results in the palliation of a wide variety of neoplastic diseases. However, the most consistent results have been seen in the following tumors: 1. Adenocarcinoma of the breast. 2. Adenocarcinoma of the ovary. 3. For controlling intracavitary effusions secondary to diffuse or localized neoplastic diseases of various serosal cavities. 4. For the treatment of superficial papillary carcinoma of the urinary bladder. While now largely superseded by other treatments, thiotepa has been effective against other lymphomas, such as lymphosarcoma and Hodgkin's disease. /Included in US product label/

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b19b03db-471d-4ee7-b1b8-6eccc39c41b0


Thiotepa has been used as an ophthalmic instillation to prevent the recurrence of pterygium following surgical excision; however, postoperative beta-irradiation is generally preferred as preventive therapy because it results in a low incidence of recurrence and is relatively easy to administer. Many clinicians recommend that the use of thiotepa be limited to the management of pterygium which recurs following postoperative beta-irradiation. /NOT included in US product label/

American Society of Health-System Pharmacists 2016; Drug Information 2016. Bethesda, MD. 2016


For more Therapeutic Uses (Complete) data for Thiotepa (6 total), please visit the HSDB record page.


4.3 Drug Warning

Ophthalmic instillation of thiotepa may occasionally produce irritation or periorbital skin depigmentation; the depigmentation usually occurs 6 months or longer after cessation of treatment. Intrathecal administration of thiotepa has been associated with lower extremity weakness and pain and demyelination within the spinal cord in some patients; transient paresthesia of the lower extremities also has occurred following intrathecal administration of hypertonic solutions of the drug.

American Society of Health-System Pharmacists 2016; Drug Information 2016. Bethesda, MD. 2016


Other reported adverse effects of thiotepa include pain at the injection site, headache, dizziness, blurred vision, conjunctivitis, dysuria, urinary retention, amenorrhea, and tightness of the throat. Some symptoms such as hyperuricemia or febrile reactions and exudation from subcutaneous lesions may be due to breakdown of tumor tissue. In some patients, intravesical administration of thiotepa has been reported to produce lower abdominal pain, vesical irritability, hematuria, and rarely hemorrhagic chemical cystitis.

American Society of Health-System Pharmacists 2016; Drug Information 2016. Bethesda, MD. 2016


Hypersensitivity reactions, including allergic reactions, rash, urticaria, laryngeal edema, asthma, anaphylactic shock, and wheezing have occurred in patients receiving thiotepa. Contact dermatitis and alopecia also have been reported. Skin depigmentation has been reported following topical use of the drug.

American Society of Health-System Pharmacists 2016; Drug Information 2016. Bethesda, MD. 2016


Nausea, vomiting, abdominal pain, and anorexia occur infrequently after administration of thiotepa. Stomatitis and ulceration of the intestinal mucosa also have been reported.

American Society of Health-System Pharmacists 2016; Drug Information 2016. Bethesda, MD. 2016


For more Drug Warnings (Complete) data for Thiotepa (15 total), please visit the HSDB record page.


4.4 Drug Indication

ThioTEPA is used a as conditioning treatment prior to allogeneic or autologous haematopoietic progenitor cell transplantation (HPCT) in haematological diseases in adult and paediatric patients. Also, when high dose chemotherapy with HPCT support it is appropriate for the treatment of solid tumours in adult and paediatric patients.


In combination with other chemotherapy medicinal products:

- with or without total body irradiation (TBI), as conditioning treatment prior to allogeneic or autologous haematopoietic progenitor cell transplantation (HPCT) in haematological diseases in adult and paediatric patients;

- when high dose chemotherapy with HPCT support is appropriate for the treatment of solid tumours in adult and paediatric patients. ". It is proposed that Tepadina must be prescribed by physicians experienced in conditioning treatment prior to haematopoietic progenitor cell transplantation.


5 Pharmacology and Biochemistry
5.1 Pharmacology

The unstable nitrogen-carbon groups alkylate with DNA causing irrepairable DNA damage. They stop tumor growth by crosslinking guanine nucleobases in DNA double-helix strands, directly attacking DNA. This makes the strands unable to uncoil and separate. As this is necessary in DNA replication, the cells can no longer divide. These drugs act nonspecifically.


5.2 MeSH Pharmacological Classification

Antineoplastic Agents, Alkylating

A class of drugs that differs from other alkylating agents used clinically in that they are monofunctional and thus unable to cross-link cellular macromolecules. Among their common properties are a requirement for metabolic activation to intermediates with antitumor efficacy and the presence in their chemical structures of N-methyl groups, that after metabolism, can covalently modify cellular DNA. The precise mechanisms by which each of these drugs acts to kill tumor cells are not completely understood. (From AMA, Drug Evaluations Annual, 1994, p2026) (See all compounds classified as Antineoplastic Agents, Alkylating.)


Myeloablative Agonists

Agents that destroy bone marrow activity. They are used to prepare patients for BONE MARROW TRANSPLANTATION or STEM CELL TRANSPLANTATION. (See all compounds classified as Myeloablative Agonists.)


5.3 FDA Pharmacological Classification
5.3.1 Active Moiety
THIOTEPA
5.3.2 FDA UNII
905Z5W3GKH
5.3.3 Pharmacological Classes
Alkylating Drug [EPC]; Alkylating Activity [MoA]
5.4 ATC Code

L01AC01


L01AC01

S76 | LUXPHARMA | Pharmaceuticals Marketed in Luxembourg | Pharmaceuticals marketed in Luxembourg, as published by d'Gesondheetskeess (CNS, la caisse nationale de sante, www.cns.lu), mapped by name to structures using CompTox by R. Singh et al. (in prep.). List downloaded from https://cns.public.lu/en/legislations/textes-coordonnes/liste-med-comm.html. Dataset DOI:10.5281/zenodo.4587355


L - Antineoplastic and immunomodulating agents

L01 - Antineoplastic agents

L01A - Alkylating agents

L01AC - Ethylene imines

L01AC01 - Thiotepa


5.5 Absorption, Distribution and Excretion

Route of Elimination

Urinary excretion of 14C-labeled thiotepa and metabolites in a 34-year old patient with metastatic carcinoma of the cecum who received a dose of 0.3 mg/kg intravenously was 63%.


Clearance

446 +/- 63 mL/min [female patients (45 to 84 years) with advanced stage ovarian cancer receiving 60 mg and 80 mg thiotepa by intravenous infusion on subsequent courses given at 4-week intervals]


In man, 50% of injection of (14)C-thiotepa either iv or locally into tumor was excreted in the first 6 hr and by 48 hr only low levels persisted. Absorption of orally administered dose of (14)C-thiotepa was variable: less than 1% of injected dose was recovered as unchanged drug in the urine.

IARC. Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Humans. Geneva: World Health Organization, International Agency for Research on Cancer, 1972-PRESENT. (Multivolume work). Available at: https://monographs.iarc.fr/ENG/Classification/index.php, p. V9 89 (1975)


... Five min after intravenous or intraarterial injection of labelled thiotepa in Sprague-Dawley rats, slightly higher levels of radioactivity were found in plasma, heart, kidneys and lungs, compared to other organs; 94-98% of radioactivity administered intravenously was excreted in urine within 8.5 hr. Most of the urinary radioactivity was associated with unchanged thiotepa; tris(l-azridinyl)phosphine oxide (tepa) was responsible for about 30% of the radioactivity.

IARC. Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Humans. Geneva: World Health Organization, International Agency for Research on Cancer, 1972-PRESENT. (Multivolume work). Available at: https://monographs.iarc.fr/ENG/Classification/index.php, p. V50 127 (1990)


One hour after intraperitoneal injection of thiotepa at 9.3 mg/kg bw into Sprague-Dawley rats, radioactivity was found in plasma (5.4%), peritoneal fluid (26%), urine (1.9%), kidney (0.7%), liver (3.8%), lung (0.6%) and muscle (25.9%).

IARC. Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Humans. Geneva: World Health Organization, International Agency for Research on Cancer, 1972-PRESENT. (Multivolume work). Available at: https://monographs.iarc.fr/ENG/Classification/index.php, p. V50 127 (1990)


In patients with normal renal function, thiotepa, triethylenephosphoramide (TEPA), and unidentified metabolites with alkylating activity are excreted in urine. Urinary excretion of thiotepa, TEPA, and unidentified metabolites with alkylating activity is about 0.1-1.5, 4, and 13-24% of the dose, respectively, within the first 24-48 hours; urinary excretion of the parent drug is complete within the first 6-8 hours. Fecal excretion of the drug and its metabolites has not been studied. Following IV administration of high doses of thiotepa, the drug apparently is excreted in sweat to an appreciable extent.

American Society of Health-System Pharmacists 2016; Drug Information 2016. Bethesda, MD. 2016


For more Absorption, Distribution and Excretion (Complete) data for Thiotepa (14 total), please visit the HSDB record page.


5.6 Metabolism/Metabolites

The major urinary metabolite in rats, rabbits and dogs following a single intravenous injection of (32)P-thiotepa was tepa, which is also an alkylating agent. Most of the radioactivity in mouse urine, however, was rccovered as inorganic phosphate.

IARC. Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Humans. Geneva: World Health Organization, International Agency for Research on Cancer, 1972-PRESENT. (Multivolume work). Available at: https://monographs.iarc.fr/ENG/Classification/index.php, p. V50 128 (1990)


... Five min after intravenous or intraarterial injection of labelled thiotepa in Sprague-Dawley rats, slightly higher levels of radioactivity were found in plasma, heart, kidneys and lungs, compared to other organs; 94-98% of radioactivity administered intravenously was excreted in urine within 8.5 hr. Most of the urinary radioactivity was associated with unchanged thiotepa; tris(l-azridinyl)phosphine oxide (tepa) was responsible for about 30% of the radioactivity.

IARC. Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Humans. Geneva: World Health Organization, International Agency for Research on Cancer, 1972-PRESENT. (Multivolume work). Available at: https://monographs.iarc.fr/ENG/Classification/index.php, p. V50 127 (1990)


In mice, thiotepa is rapidly metabolized to tris (1-aziridinyl)phosphine oxide (tepa): with 30 minutes only tepa and inorganic phosphate were detected in the urine and plasma. The mouse is exceptional in its ability to degrade the drug completely to inorganic phosphate.

IARC. Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Humans. Geneva: World Health Organization, International Agency for Research on Cancer, 1972-PRESENT. (Multivolume work). Available at: https://monographs.iarc.fr/ENG/Classification/index.php, p. V9 89 (1975)


Thiotepa appears to be extensively metabolized in the liver by the cytochrome P-450 microsomal enzyme system, principally via oxidative desulfuration to a triethylenephosphoramide (TEPA). Although TEPA is the only metabolite detected and identified in plasma, there is evidence that other unidentified metabolites also are formed. Following rapid IV injection of thiotepa in adults with normal renal and hepatic function, plasma concentrations of the drug appear to decline in a biphasic manner with a half-life of approximately 6-12 minutes in the initial phase and 1.2-2.9 hours in the terminal phase. The plasma elimination half-life of TEPA is about 10-21 hours.

American Society of Health-System Pharmacists 2016; Drug Information 2016. Bethesda, MD. 2016


The urinary excretion of N,N',N"-triethylenethiophosphoramide (thioTEPA), and its metabolites N,N',N"-triethylenephosphoramide (TEPA), N,N'-diethylene,N"-2-chloroethylphosphoramide (monochloroTEPA) and thioTEPA--mercapturate was determined in patients receiving thioTEPA as part of a high-dose combination chemotherapy regimen with cyclophosphamide and carboplatin. The thioTEPA dose was 40 or 60 mg/sq m in short infusions, twice daily, during 4 days. Urine samples were collected after each voiding on each day of drug administration until 24-48 h after the last thioTEPA infusion. ThioTEPA, TEPA and monochloroTEPA concentrations were determined with gas chromatography and thioTEPA--mercapturate with liquid chromatography-mass spectrometry with direct sample injection. ThioTEPA was present in urine 30 min after infusion and was still excreted 18 hr after the last infusion. All metabolites were detected in urine 1 hr after infusion. Patients with a creatinine clearance above 140 ml/minl showed higher excretion of TEPA than patients with a creatinine clearance below 140 mL/min (12.8 versus 4.9%, p=0.01). The excretion of monochloroTEPA relative to the excreted amount of TEPA increased at lower pH values of the urine. The excretion of thioTEPA--mercapturate relative to the dose was higher in patients treated with 60 mg/sq m. Excretion of thioTEPA and monochloroTEPA both accounted for only 0.5% of the dose, while TEPA and thioTEPA--mercapturate both accounted for 11.1%.

PMID:11459998 van Maanen MJ et al; Anticancer Drugs 12 (6): 519-24 (2001)


5.7 Biological Half-Life

1.5 to 4.1 hours


A total of 15 patients with residual ovarian cancer confined to the peritoneal cavity after first-line systemic chemotherapy were treated with thio-tepa in a phase I study. A total of 50 courses of thio-tepa were given ip in doses ranging from 30 to 80 mg/sq m. ... Peritoneal fluid concentrations declined rapidly in a first-order fashion, with a half-life of 0.96 + or - 0.1 hr. ...

PMID:1695127 Lewis C et al; Cancer Chemother Pharmacol 26 (4): 283-7 (1990)


A biexponential decline in thiotepa concentration in plasma was seen during the first hours after intravenous injection of thiotepa at 5 mg/kg bw in Swiss-Webster mice. The half-time was 0.21 min for the first phase and 9.62 min for the second.

IARC. Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Humans. Geneva: World Health Organization, International Agency for Research on Cancer, 1972-PRESENT. (Multivolume work). Available at: https://monographs.iarc.fr/ENG/Classification/index.php, p. V50 127-8 (1990)


Following rapid IV injection of thiotepa in adults with normal renal and hepatic function, plasma concentrations of the drug appear to decline in a biphasic manner with a half-life of approximately 6-12 minutes in the initial phase and 1.2-2.9 hours in the terminal phase. The plasma elimination half-life of triethylenephosphoramide (TEPA) is about 10-21 hours.

American Society of Health-System Pharmacists 2016; Drug Information 2016. Bethesda, MD. 2016, p. 426


5.8 Mechanism of Action

The alkyl group is attached to the guanine base of DNA, at the number 7 nitrogen atom of the imidazole ring. They stop tumor growth by crosslinking guanine nucleobases in DNA double-helix strands, directly attacking DNA. This makes the strands unable to uncoil and separate. As this is necessary in DNA replication, the cells can no longer divide. These drugs act nonspecifically.


Thiotepa is a cytotoxic agent of the polyfunctional type, related chemically and pharmacologically to nitrogen mustard. The radiomimetic action of thiotepa is believed to occur through the release of ethylenimine radicals which, like irradiation, disrupt the bonds of DNA. One of the principal bond disruptions is initiated by alkylation of guanine at the N-7 position, which severs the linkage between the purine base and the sugar and liberates alkylated guanines.

NIH; DailyMed. Current Medication Information for Thiotepa (Thiotepa Injection, Powder, Lyophilized, for Solution (Updated: October 2015). Available from, as of March 31, 2017: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b19b03db-471d-4ee7-b1b8-6eccc39c41b0


The megakaryocytopoiesis in rats was studied following a single dose of thio-tepa to determine the mechanisms for the thrombocytopenia and subsequent recovery. The blood platelet number, platelet production (measured by (35)S incorporation into platelets), mean platelet volume, and the number and DNA content of bone marrow megakaryocytes were observed. The blood platelet counts, platelet production, and total megakaryocytes number decreased to low values following the administration of thio-tepa, and stayed low until regeneration started around day 10. The mean platelet volume increased from the normal 6.6 fL to 7.8 fL during the early regeneration days 8-14. The megakaryocytes were divided into four ploidy classes: 2N-4N, 8N, 16N, and 32N-64N. The number of megakaryocytes within all ploidy classes decreased to nearly zero within four days after the injection of thio-tepa. The regeneratin started around day 10 with increasing numbers of 2N-4N and 8N megakaryocytes, while the number of 16N and 32N-64N megakaryocytes increased more than four days later. It is concluded that decreased or blocked influx or progenitor cells into the megakaryocytes compartment is the main reason for thrombocytopenia after exposure to thio-tepa.

PMID:3081360 Tanum G; Exp Hematol 14 (3): 202-6 (1986)


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